Organization
COASTAL RADIOLOGY CONSULTANTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHY J THORN D.C., D.A.C.B.R. (OWNER)
(919) 562-6570
Entity
Organization
Contact information
Practice address
851 DURHAM RD, SUITE A, WAKE FOREST, NC 27587
(919) 562-6570
(919) 562-6572
Mailing address
851 A DURHAM ROAD, WAKE FOREST, NC 27587
(919) 562-6570
Taxonomy
Speciality
Code
Description
License number
State
111NR0200X
Radiology Chiropractor
Primary
2160
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7908817
—
NC
Enumeration date
09/22/2006
Last updated
08/22/2020
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